| National Provider Identifier [NPI]: | 1679773253 |
| Last Name Of The Provider | GUPTA |
| First Name Of The Provider | DEEPASHREE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3660 VISTA AVE |
| Street Address 2 Of The Provider | DOCTOR'S OFFICE BUILDING ROOM 204 |
| City Of The Provider | SAINT LOUIS |
| Zip Code Of The Provider | 631102540 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Endocrinology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 552 |
| Number Of Medicare Beneficiaries | 238 |
| Total Submitted Charge Amount | 88115 |
| Total Medicare Allowed Amount | 53448.37 |
| Total Medicare Payment Amount | 39698 |
| Total Medicare Standardized Payment Amount | 41653.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 11 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 652 |
| Total Drug Medicare AllowedAmount | 309.27 |
| Total Drug Medicare PaymentAmount | 303.06 |
| Total Drug Medicare Standardized Payment Amount | 303.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 541 |
| Number Of Medicare Beneficiaries With Medical Services | 238 |
| Total Medical Submitted Charge Amount | 87463 |
| Total Medical Medicare Allowed Amount | 53139.1 |
| Total Medical Medicare Payment Amount | 39394.94 |
| Total Medical Medicare Standardized Payment Amount | 41350.77 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 110 |
| Number Of Beneficiaries Age 65 to 74 | 87 |
| Number Of Beneficiaries Age 75 to 84 | 28 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 137 |
| Number Of Male Beneficiaries | 101 |
| Number Of Non Hispanic White Beneficiaries | 130 |
| Number Of Black or African American Beneficiaries | 95 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 138 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 100 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 74 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.4438 |